Post-surgical adhesions are of significant clinical and medico-economic relevance, since, for example, post-surgical adhesions cause about 40% of cases of chronic pelvic pain and approximately 20% of cases of infertility. Indeed, adhesions cannot be prevented without employing adjuvant therapy, and every minute trauma may result in their formation.
Many materials have been found to have a positive effect on reduction of surgical adhesions, such as sodium hyaluronate/carboxymethylcellulose films, collagen films and gels, as well as fibrin glues.
EP1905443 describes the administration of a solution containing trehalose for the reduction and/or prevention of adhesion during or after surgery.
Lee et al (Japanese Journal of Veterinary Anesthesia & Surgery, Vol. 40, pp. 19-26 (2009) disclose the reduction of experimentally-induced post-surgical adhesions of internal organs after ovariohysterectomy in a rabbit model by spraying solutions of sodium carboxymethylcellulose in conjunction with trehalose solutions onto the surface of visceral organs.
The effect of liquid fibrin glues on anti-adhesion is somewhat controversial. Many reports implied the possible prevention of post-surgical adhesions using such liquid fibrin glues (e.g. Brands et al., Chirurg 61 (1990): 22-26; Lindenberg et al., Ann. Chir. Gynecol. 73 (1984): 11-13; De laco et al., Fertility and Sterility 62 (2) (94): 400-404; Takeuchi et al., J. Am. Assoc. Gynecol. Laparosc. 3 (4) (1996): 575-579; Martin-Cartez et al., Surg Today, 2008, 38(2): 135-40). However, other studies found no significant effect in preventing adhesion formation or the effect on reproduction after adhesion complications post-surgery (see e.g. Marana et al., Gynecol. Obstet. Invest. 41 (1996): 199-202 and Gauwerky et al., Arch. Gynecol. Obstet. 247 (1990): 161-166).
Recent comparative tests indicated that collagen gels, collagen films and sodium hyaluronate/carboxymethylcellulose films effectively reduced adhesion formation, whereas the effect of liquid fibrin glues on adhesion formation was similar to the control.
It is therefore an object of the present invention to provide a method and compositions for efficiently reducing or preventing tissue adhesion in a patient.